Holzinger Daniel, Danilovic Ivan, Seemann Rudolf, Kornek Gabriela, Engelmann Johannes, Pillerstorff Robert, Holawe Simone, Psyrri Amanda, Erovic Boban M, Farwell Gregory, Perisanidis Christos
Department of Cranio-, Maxillofacial and Oral Surgery, Medical University of Vienna, Austria.
Department of Medicine I, Medical University of Vienna, Austria.
PLoS One. 2016 Jun 30;11(6):e0158697. doi: 10.1371/journal.pone.0158697. eCollection 2016.
We aimed to determine the prognostic significance of pretreatment plasma fibrinigen in patients with oral and oropharyngeal squamous cell carcinoma (OOSCC).
A cohort of 183 patients with locally advanced OOSCC receiving preoperative chemoradiotherapy was retrospectively examined. Using ROC curve analysis, a pretreatment plasma fibrinogen cutoff value of 447mg/dL was determined. The primary endpoints were overall survival and recurrence-free survival. A secondary endpoint was to determine whether pretreatment plasma fibrinogen could predict treatment response to neoadjuvant chemoradiotherapy. Cox regression models and Kaplan-Meier curves were used for survival analyses.
Seventy-one patients had an elevated pretreatment plasma fibrinogen (fibrinogen >447mg/dL). Patients with high fibrinogen showed significantly higher pathologic stages after neoadjuvant treatment than those with low fibrinogen (p = 0.037). In univariate analysis, elevated fibrinogen was associated with poor overall survival (p = 0.005) and recurrence-free survival (p = 0.008) Multivariate analysis revealed that elevated fibrinogen remained an independent risk factor for death (hazard ratio 1.78, 95% CI 1.09-2.90, p = 0.021) and relapse (hazard ratio 1.78, 95% CI 1.11-2.86, p = 0.016).
Elevated pretreatment plasma fibrinogen is associated with lack of response to neoadjuvant chemoradiotherapy and reduced OS and RFS in patients with OOSCC. Thus, plasma fibrinogen may emerge as a novel prognostic indicator and a potential therapeutic target in OOSCC.
我们旨在确定治疗前血浆纤维蛋白原在口腔和口咽鳞状细胞癌（OOSCC）患者中的预后意义。
回顾性研究了183例接受术前放化疗的局部晚期OOSCC患者队列。通过ROC曲线分析，确定治疗前血浆纤维蛋白原的临界值为447mg/dL。主要终点为总生存期和无复发生存期。次要终点是确定治疗前血浆纤维蛋白原是否可预测新辅助放化疗的治疗反应。采用Cox回归模型和Kaplan-Meier曲线进行生存分析。
71例患者治疗前血浆纤维蛋白原升高（纤维蛋白原>447mg/dL）。纤维蛋白原水平高的患者在新辅助治疗后的病理分期显著高于纤维蛋白原水平低的患者（p = 0.037）。单因素分析显示，纤维蛋白原升高与较差的总生存期（p = 0.005）和无复发生存期（p = 0.008）相关。多因素分析显示，纤维蛋白原升高仍然是死亡（风险比1.78，95%CI 1.09 - 2.90，p = 0.021）和复发（风险比1.78，95%CI 1.11 - 2.86，p = 0.016）的独立危险因素。
治疗前血浆纤维蛋白原升高与OOSCC患者对新辅助放化疗无反应以及总生存期和无复发生存期降低相关。因此，血浆纤维蛋白原可能成为OOSCC一种新的预后指标和潜在的治疗靶点。
